Neurosurgery
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Comparative Study
Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures.
To report on indications, surgical technique, results, and morbidity of stereoelectroencephalography (SEEG) in the presurgical evaluation of patients with drug-resistant focal epilepsy. ⋯ SEEG is a useful and relatively safe tool in the evaluation of surgical candidates when noninvasive investigations fail to localize the epileptogenic zone. SEEG-based resective surgery may provide excellent results in particularly complex drug-resistant epilepsies.
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Review Case Reports
Spinal arachnoid cyst related to a nonaneurysmal perimesencephalic subarachnoid hemorrhage: case report.
We report the first case of a delayed symptomatic spinal arachnoid cyst related to a nonaneurysmal perimesencephalic hemorrhage. We review the literature concerning posthemorrhagic spinal arachnoid cysts. ⋯ This extremely rare complication should be kept in mind when delayed lower-limb neurological deficits appear after subarachnoid hemorrhage, even in a perimesencephalic form.
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Review Case Reports Comparative Study
"Disc cysts" and "posterior longitudinal ligament ganglion cysts": synonymous entities? Report of three cases and literature review.
Extradural cysts intimately associated with relatively normal lumbar discs have rarely been reported. Histologically nonspecific, most have been designated posterior longitudinal ligament (PLL) or annulus fibrosus (AF) "ganglion cysts." Recently, "disc cysts" have been distinguished as a separate entity, mostly on the grounds of cyst-disc communication. ⋯ Our results and those of others suggest that all such cysts are ganglion cysts that derive from either the AF or the PLL at the disc level. Although disc cysts might be AF ganglion cysts exhibiting disc communication, their separate distinction is probably unnecessary. Cystectomy alone affords complete symptomatic remission; discectomy is usually unnecessary. Although anticipated with ganglia in general, neither spontaneous resolution nor postoperative recurrences have been witnessed. Unlike ganglia in general or juxtafacet ganglion cysts, such cysts seem to be unusually restricted to young men.
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Review Comparative Study Clinical Trial
Olfactory groove meningiomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes.
To review the surgical approaches, techniques, outcomes, and recurrence rates in a series of 80 olfactory groove meningioma (OGM) patients operated on between 1990 and 2003. ⋯ A variety of surgical approaches are used for OGM resection. An approach tailored to the tumor's size, location, and extension, combined with modern microsurgical cranial base techniques, allows full OGM removal with minimal permanent morbidity, excellent neurological outcome, and very low recurrence rates.
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Comparative Study
Effects of 23.4% sodium chloride solution in reducing intracranial pressure in patients with traumatic brain injury: a preliminary study.
Mannitol is the standard of care for patients with increased intracranial pressure (ICP), but multiple administrations of mannitol risk renal toxicity and fluid accumulation in the brain parenchyma with consequent worsening of cerebral edema. This preliminary study assessed the safety and efficacy of small-volume injections of 23.4% sodium chloride solution for the treatment of intracranial hypertension in patients with traumatic brain injury who became tolerant to mannitol. ⋯ This study suggests that 23.4% hypertonic saline is a safe and effective treatment for elevated ICP in patients after traumatic brain injury. These results warrant a rigorous evaluation of its efficacy as compared to mannitol in a prospective randomized controlled trial.